2. Congress should authorize the secretary to direct funding from the budgets of all departmental units to support the development of an HHS-wide information system. Funding for such a system would benefit all department units.

As indicated, the kind of system envisioned by the IOM committee would generate actionable feedback about how health and human services programs are working, whether they need midcourse corrections, or whether they are performing poorly—in ways that cannot be corrected or are too costly for the benefit achieved—and should be terminated. The secretary must make clear that the purpose of the reporting system is to stimulate improvements in the performance of the department and its constituent units, and that system results will guide decisions about current programs and plans for new investments. As each HHS unit works toward its own integrated vision, mission, and goals, the system will be helpful in program management and tracking.

This system could be described as a “neural network” for the department and is a key component of value creation. It would enable a panoramic view across all health and human services programs and inform the secretary how the department’s programs are coordinating their efforts to achieve departmental—as well as individual program—goals. It would enable the integration of data on costs and benefits to show the value received by program beneficiaries and the public. And it should allow the secretary and Congress “to periodically reexamine whether current programs and activities remain relevant, appropriate, and effective in delivering the government that Americans want, need, and can afford” (GAO, 2003).

The new system would not be solely an information resource for the federal government, but also could serve health care organizations in the public and private sectors at the national, state, and local levels. Just like the other performance data available today, the system also should be available to Congress and the public in an electronic, easily accessible, and readily understood form.

The secretary, in collaboration with the surgeon general, could draw on this system to create a brief, annual “State of the Nation’s Health” report to Congress (perhaps in a joint session involving members of the